- Excellus BlueCross BlueShield (Rochester, NY)
- …Essential Accountabilities: Level I . Analyzes and audits acute inpatient claims . Integrates medical chart coding principles, clinical guidelines, and objectivity in ... Ensures accurate payment by independently utilizing DRG grouper, encoder, and claims processing platform. . Manages case volumes and review/audit schedules,… more
- University of Rochester (Albany, NY)
- …(EOBs), insurance correspondence, rejections received thru daily electronic and claims submission, etc. Research claims , identify problems, and takes ... of the individual, and internal equity considerations._ **Responsibilities:** The Claims Resolution Representative III is responsible for working across the… more
- NJM Insurance (Trenton, NJ)
- …first point of contact for policyholders, claimants or other parties reporting claims . They are responsible for addressing customer inquiries concerning the claim ... to accurately and efficiently establish new Auto, Property and Commercial claims . Schedule: Monday to Saturday (10:45am-7:00pm). Includes one weekday and Sundays… more
- The County of Los Angeles (Los Angeles, CA)
- …compensation indemnity claims , -AND- possession of a valid California Self Insurance Certification of Achievement, obtained by passing the California State Self ... Insurance Plans exam. License A valid California Class C...steps to view correspondence, and we will not consider claims of missing notices to be a valid reason… more
- US Tech Solutions (Columbia, SC)
- …is not limited to, support of communication interfaces/transactions/functions as required by insurance laws (such as support of claims , remit advices, ... inquiry/response for claims status/eligibility, enrollment, premium payment etc.), support of all current formats/transactions required by law/ lines of business. *40% Responsible for the setup of all electronic transactions submission by processing… more
- Philadelphia Insurance Companies (Ewing, NJ)
- …Philadelphia Insurance Companies, Tokio Marine America, Inc., TMNA Services, LLC, TM Claims Service, Inc. and First Insurance Company of Hawaii, Ltd.) is an ... Description Marketing Statement: Philadelphia Insurance Companies, a member of the Tokio Marine...with functional leaders in Actuarial, IT, Stat, Underwriting and Claims throughout the product development cycle. Responsible for the… more
- Sedgwick (Cincinnati, OH)
- …Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Service Center Representative | Cincinnati, OH (In-Office) | 3p-11p Shift **PRIMARY ... PURPOSE** **:** To provide excellent service to callers regarding claims for multiple lines of business; to expedite the claims application process and provide… more
- Sedgwick (Boston, MA)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Sr. Professional Liability Consultant - PRN **This PRN Legal Nurse Consultant ... opportunity plays a key role in supporting our general liability claims team. The ideal candidate will bring strong clinical expertise and analytical skills to help… more
- AIG (Lenexa, KS)
- …skills and experience as a valued member of the team. Make your mark in Claims Stewardship Our Claims professionals support AIG policyholders through some of the ... a lost family heirloom or a prized possession. Our Claims team is an industry leader, drawing daily on...peace of mind to you and your family. Reimagining insurance to make a bigger difference to the world… more
- Firefly Health (Watertown, MA)
- …internal team and answers, and also investigating and resolving billing and claims inquiries all within established service level agreements (SLAs). This role ... seamlessly between explaining plan designs to a member and digging into technical claims adjudication issues with providers. You will: Member & Provider Support +… more
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